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Mammography of both breasts

DETAIL FOR SERVICES: Study Radiologist reading (interpretation)
2020 CPT/HCPCS Primary Code 77066 Not provided by Hospital (may be billed separately)
Negotiated Private Fee $170.00 Not provided by Hospital (may be billed separately)
Prossam $42.50 Not provided by Hospital (may be billed separately)
Champva $165.37 Not provided by Hospital (may be billed separately)
First Medical $40.00 Not provided by Hospital (may be billed separately)
First Medical Vital $85.05 Not provided by Hospital (may be billed separately)
Plan de Salud Menonita $42.50 Not provided by Hospital (may be billed separately)
Menonita Vital $78.82 Not provided by Hospital (may be billed separately)
Humana Gold Plus / Gold Choice $121.21 Not provided by Hospital (may be billed separately)
Humana $52.50 Not provided by Hospital (may be billed separately)
Mapfre $54.00 Not provided by Hospital (may be billed separately)
Mcsclassicare $52.50 Not provided by Hospital (may be billed separately)
MCS Life $70.00 Not provided by Hospital (may be billed separately)
Medicare $165.37 Not provided by Hospital (may be billed separately)
MMM $109.35 Not provided by Hospital (may be billed separately)
MMM Vital $86.53 Not provided by Hospital (may be billed separately)
Panamerican Life $35.00 Not provided by Hospital (may be billed separately)
PMC $109.35 Not provided by Hospital (may be billed separately)
Tricare $165.37 Not provided by Hospital (may be billed separately)
Triple S Salud $41.00 Not provided by Hospital (may be billed separately)
Triple S Vital $28.77 Not provided by Hospital (may be billed separately)
Triple S Advantage $121.21 Not provided by Hospital (may be billed separately)
Negotiated Minimum Charge $28.77 Not provided by Hospital (may be billed separately)
Negotiated Maximum Charge $165.37 Not provided by Hospital (may be billed separately)
Discounted Cash Price $136.00 Not provided by Hospital (may be billed separately)

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